HIV Treatment Adherence

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Treatment adherence means taking the correct dose of your medications every time, exactly as prescribed by your health care provider or recommended by your pharmacist. To successfully halt HIV replication and keep viral load suppressed, HIV meds need to be maintained at high enough levels in the blood, 24 hours a day, every day. If the drug levels become too low, drug resistance may occur.

HIV drug resistance can cause your meds to stop working properly and may limit future treatment options. It is also possible to transmit drug-resistant HIV to other people, making it harder for them to treat their own infection.

When selecting a new HIV medication or starting meds for the first time, you may want to look at your lifestyle to see if there are any potential adherence obstacles. Here is a list of questions for you to consider when discussing adherence and making treatment decisions with your health care provider:

Does your daily schedule change a lot?

What is your typical eating schedule each day?

Do you have a difficult time swallowing pills?

Are you taking other medications?

What side effects can you tolerate?

What happens if you miss a dose?

Today, there are several once-daily fixed-dose regimens contained in one pill. While the option of only taking one pill a day sounds appealing, these regimens may not allow for a missed dose because the doses are further apart than twice-daily doses. Missing a once-daily dosed pill could also cause drug resistance.

Treatment adherence can affect anyone. Don’t feel guilty about talking to your doctor about any difficulty you may have with taking your medications on time. There are certain situations that have been found to affect adherence.

Attitude: People who feel most strongly that their medication is doing them good typically have an easier time adhering to their regimens. Understanding how and why the medications work can help with adherence.

Mood: People who are depressed have a harder time adhering to HIV drug regimens than people who are not depressed. If you suspect you are depressed, talk to you health care provider.

Disorder: The amount of disorder in your life, and the stress it creates, can generate adherence problems. Disorder can include more than just an unpredictable and overwhelming schedule of activities. Try to identify and lower the disorder in your life. Your health care provider or case manager may be able to help.

Primary Caregiver: The needs and concerns of the people you’re caring for can be overwhelming and become your primary focus. It’s important to remember that your health must come first; you can’t care for others if you don’t take care of yourself.

Talk to your health care provider if you need help addressing any adherence challenges. Finding other people in your situation can also help. Join a support group or connect with other HIV-positive people in the POZ Forums.

Adherence Tips and Tools

Adherence problems aren’t something to be ashamed of. It’s important to discuss any fears or challenges you have with your health care provider. There are also many tips and tools you can use to help you better adhere to HIV treatment:

Practice with jellybeans or M&Ms. Think of it as an experiment to see if you can adhere to a treatment regimen. Practice for two weeks and talk with your health care provider about any challenges you faced along the way.

Keep your meds next to something you use regularly. If you see your meds near something you use on a daily basis, it can help tremendously. Examples include your coffee pot, your alarm clock or your toothbrush.

Sign up for a reminder service. Many AIDS service organizations and pharmacies have a free program that will call to remind you to take your medications. You can also find free reminder services online that will send you a text message or email every day at the times you specify. (For a free online program unaffiliated with any pharmaceutical company, click here.)

Program your cell phone. Set an alarm on your phone at various times of the day and night. People may be less likely to ask about your cell phone ringing than if you’ve set an alarm on a watch or other device.

Travel with extra doses. If you travel frequently, always bring your meds in your carry-on luggage, and bring a few extra doses in case of flight delays and cancellations.

Stay on schedule. Some people have more trouble remembering to take their medication on their days off work or school, or other times when their schedule is different than usual. You may need additional support remembering your medication on days like this.

Organize your meds. One-week, two-week and one-month pillboxes are available to help you lay out your meds in advance. Many people with HIV use these affordable and handy organizing devices. Some pharmacies will sort out your daily dose of meds and organize and package them in blister packs rather than putting them into pill bottles.

Meds on the go. If you find that you regularly need to take your meds on the go, check out portable pocket-sized pill cases. Some even have built-in timers.

Plan ahead. Make sure that you regularly refill your prescriptions so you don’t run out of your medications.

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